Motley M, Sarafian S K, Knapp J S, Zaidi A A, Schmid G
Department of Microbiology and Immunology, Morehouse School of Medicine, Atlanta, Georgia 30310.
Antimicrob Agents Chemother. 1992 Aug;36(8):1639-43. doi: 10.1128/AAC.36.8.1639.
We determined the susceptibilities of 94 strains of Haemophilus ducreyi isolated in various municipalities in the United States between 1982 and 1989 to the following antimicrobial agents: amoxicillin-clavulanic acid, ceftriaxone, erythromycin, azithromycin, ciprofloxacin, ofloxacin, trimethoprim, and spectinomycin. Ceftriaxone (MIC, less than or equal to 0.008 micrograms/ml), azithromycin (MIC, less than or equal to 0.125 micrograms/ml), erythromycin (MIC, less than or equal to 0.125 micrograms/ml), ciprofloxacin (MIC, less than or equal to 0.25 micrograms/ml), and ofloxacin (MIC, less than or equal to 0.25 micrograms/ml) were highly active against all isolates. Amoxicillin-clavulanic acid (MICs, 0.25 to 8.0 micrograms/ml), trimethoprim (MICs, 0.06 to 16.0 micrograms/ml), and spectinomycin (MICs, 2.0 to greater than or equal to 32.0 micrograms/ml) were less active against these isolates. Isolates possessing the 5.7-MDa beta-lactamase plasmid were less susceptible to erythromycin, trimethoprim, and spectinomycin than were isolates possessing the 3.2-MDa beta-lactamase plasmid. The susceptibilities of plasmidless isolates to erythromycin, trimethoprim, and spectinomycin were distributed bimodally; the median MIC for the more susceptible plasmidless isolates corresponded to that for isolates with the 3.2-MDa plasmid, and the median MIC for the less susceptible plasmidless isolates corresponded to that for isolates with the 5.7-MDa plasmid. Thus, plasmid profiles may be valuable markers for geographical variations in antimicrobial susceptibilities of H. ducreyi strains that may indicate the relative efficacy of regimens for the treatment of chancroid. Of the regimens recommended by the U.S. Public Health Service for the treatment of chancroid, our results support the use of erythromycin, ceftriaxone, and ciprofloxacin, and perhaps ofloxacin, but suggest that amoxicillin-clavulanic acid and sulfamethoxazole-trimethoprim should be used with caution.
我们测定了1982年至1989年间在美国不同城市分离出的94株杜克雷嗜血杆菌对以下抗菌药物的敏感性：阿莫西林-克拉维酸、头孢曲松、红霉素、阿奇霉素、环丙沙星、氧氟沙星、甲氧苄啶和壮观霉素。头孢曲松（MIC，小于或等于0.008微克/毫升）、阿奇霉素（MIC，小于或等于0.125微克/毫升）、红霉素（MIC，小于或等于0.125微克/毫升）、环丙沙星（MIC，小于或等于0.25微克/毫升）和氧氟沙星（MIC，小于或等于0.25微克/毫升）对所有分离株均具有高度活性。阿莫西林-克拉维酸（MIC，0.25至8.0微克/毫升）、甲氧苄啶（MIC，0.06至16.0微克/毫升）和壮观霉素（MIC，2.0至大于或等于32.0微克/毫升）对这些分离株的活性较低。携带5.7-MDaβ-内酰胺酶质粒的分离株比携带3.2-MDaβ-内酰胺酶质粒的分离株对红霉素、甲氧苄啶和壮观霉素的敏感性更低。无质粒分离株对红霉素、甲氧苄啶和壮观霉素的敏感性呈双峰分布；较敏感的无质粒分离株的MIC中位数与携带3.2-MDa质粒的分离株相当，而较不敏感的无质粒分离株的MIC中位数与携带5.7-MDa质粒的分离株相当。因此，质粒图谱可能是杜克雷嗜血杆菌菌株抗菌药物敏感性地理差异的有价值标志物，这可能表明软下疳治疗方案的相对疗效。在美国公共卫生服务局推荐的软下疳治疗方案中，我们的结果支持使用红霉素、头孢曲松和环丙沙星，或许还有氧氟沙星，但建议谨慎使用阿莫西林-克拉维酸和磺胺甲恶唑-甲氧苄啶。
